Use of Topical Heparin

EVIDENCES

• A total of 1055 patients participated in a total of 20 studies that compared topical heparin formulations in the treatment of superficial thrombophlebitis or venous insufficiency.
• Heparin gel 1000 IU/g (Lioton) 1000 gel, Menaven) 1000 gel) was more effective than placebo in reducing the signs and symptoms of superficial thrombophlebitis.
• Liposomal heparin gel 2400 IU/g (LipoHep Forte) was as effective as subcutaneous low-molecular-weight heparin at relieving local symptoms of superficial venous thrombosis.
• all preparations appeared effective but heparin gel 1000 IU/g was superior to a heparinoid mucopolysaccharide cream (Hirudoid) in patients with vascular disorders in terms of resolving spontaneous pain, induced pain, oedema and heaviness in the limb
• All treatments were generally well tolerated, with a relatively low incidence of local skin events.
• current comparative study demonstrates that heparin significantly decreases the requirement of analgesics and the time required to prepare a burn wound for grafting. Besides as compared to silver sulfadiazine dressings, heparin appears to be cost-effective

CONCLUSION

• May be useful for relieving the signs and symptoms of vascular disorders while improving microcirculation.
• There is some evidence to suggest that heparin gel 1000 IU/g may be more effective than other topical preparations in treating these conditions, possibly because of the relatively high heparin levels in this formulation. This remains to be tested in well controlled, adequately powered clinical trials.

FURTHER INFORMATION:

• Three main local actions of heparin on the skin can be defined:
• anticoagulant action
• microcirculatory-modulatory action determining important control of the microcirculation in case of excessive vasoconstriction or vasodilatation
• 'facilitatory action' on skin permeability allowing other drugs to diffuse better and faster into the skin (producing a therapeutic effect)

REFERENCES

1. Topically applied heparins for the treatment of vascular disorders : a comprehensive review http://www.ncbi.nlm.nih.gov/pubmed/18783299
2. Topical heparin versus conventional treatment in acute burns: A comparative study http://www.ijburns.com/article.asp?issn=0971-653X;year=2014;volume=22;issue=1;spage=43;epage=50;aulast=Masoud